HIA and sustainable travel HIA Forum, Cork City Hall 4 November 2010 Teresa Lavin Institute of Public Health in Ireland www.publichealth.ie

Health Impact Assessment A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population Gothenburg Consensus 1999

HIA • Aims to improve health from a social determinants of health perspective • Provides a mechanism for health inequalities to be considered • Is a multi-disciplinary process • Is participatory and inclusive • Supports evidence-based decision making

Aims of HIA HIA aims to improve health and reduce health inequalities by: • Systematically considering how a proposal may affect the health of a population and/or particular groups within that population • Providing recommendations on how a proposal could be modified to maximise opportunities for health gain and minimise chances of health loss

Aims of HIA HIA aims to improve decision-making through: • Following a clear, transparent process • Ensuring recommendations are evidence-based • Providing a mechanism for those affected by the proposal to engage with the issues

Timing

Proposal at a stage where some information is available

Proposal at a stage where further information/ recommendatio ns will be considered

Policy/ project stage • Prospective – HIA conducted when the proposal is being developed • Concurrent – HIA conducted when the proposal is being implemented • Retrospective – HIA conducted when the proposal has already been implemented

Depth of HIA • Desktop HIA - Conducted quickly and with limited resources • Rapid HIA – Uses a broader range of evidence • Comprehensive HIA - Undertaken over longer period of time and requires more resources

HIA process Screening Scoping Appraisal Recommendations Implementation of recommendations Monitoring and evaluation

Community profile Data collection: Qualitative and quantitative methods Impact analysis: Data collated and assessed Priority health impacts identified

Scoping – Issues to consider •Aims and objectives of the HIA •Time line – identify key dates •Non-negotiable aspects of the proposal •Resources for HIA •Who should be involved? –Steering group –Working group? –Stakeholders and key informants •Agree information needed for HIA

Role of the Steering Group • Facilitate access to information and key informants • Appraise the evidence • Agree recommendations • Approve the final HIA report • Potentially contribute to monitoring and evaluation of the HIA • Appoint external consultant if required

Gathering information in HIA • Information about the population (community profile) • Further information about the proposal if available • Review of policy relevant to the proposal • Evidence of potential health impacts identified in the proposal (from literature & stakeholders)

Engaging stakeholders • Opportunity for those affected by the proposal to contribute to decision-making process • Can strengthen evidence by: – Helping to contextualise evidence from elsewhere – Drawing out local issues of concern which may not be reflected in the literature • Various methods such as: – Public meetings, Focus groups – Interviews, Surveys

IPH work in HIA • Skills development: Broad range of opportunities from awareness raising to comprehensive training • Information: Health impact reviews series; Website • Partnerships: HIA network; HIA forum; HIA conference • Practice: Active involvement in HIAs currently being undertaken See www.publichealth.ie/hia for further information

Active travel and health

Active travel and health on the island of Ireland • Currently low levels of active travel across Ireland • Personal, socio-cultural and environmental factors influence decisions on travel mode such as attitude, information and experience, time and complexity of journey, proximity of destination and accessibility • Scope for change - many short car journeys could be replaced by walking and cycling

Active travel and health on the island of Ireland • Immediate health benefits for individuals through increased physical activity • Population wide benefits accrue as more people switch to walking and cycling including less traffic accidents, less noise, reduced greenhouse gas emissions, better air quality and improved quality of life • The cost of creating environments to support walking and cycling is a fraction of the savings made through better population health

Active travel and health on the island of Ireland • Health should be a central component of sustainable travel • Equity must be a key consideration in all interventions to increase active travel • Creation and maintenance of environments that support walking and cycling • Incentives to encourage active travel and disincentives for sedentary travel • Education & information addressing personal travel behaviours • Better information on journeys other than to work or school

Rapid HIA of the Green Travel Plan for EHSSB Proposal analysis: • The Green Travel Plan included 25 proposals in 7 areas: Access; Cycling; Public Transport; Parking; Ways of working; Information; Events • The HIA considered proposals in 5 areas as these were considered to be of direct relevance to EHSSB employees, the others being more strategic in nature

Rapid HIA of the Green Travel Plan for EHSSB Information used: • Evidence was sourced on the health impacts of transport • Information on current employee travel practice was obtained from a previously conducted staff survey. A profile of employees was prepared in consultation with the Personnel Dept • A participatory workshop was held which included representation from stakeholders, key informants and decision makers as well as a cross section of departments, grades & locations

Rapid HIA of the Green Travel Plan for EHSSB At the workshop: • Vulnerable groups were identified including employees with chronic health problems, disabilities, those located outside BMAP and those on lower incomes • Conflicts and barriers to implementing the proposal were identified • Health impacts of proposals within pre-selected areas of the Travel Plan under were identified and participants discussed how potential negative impacts could be mitigated

Rapid HIA of the Green Travel Plan for EHSSB Potential negative impact Difficulties in conducting complex trips without a car

Suggestion

Develop personal travel plans Improve non-car access to gyms/ childcare Working from home may Training and information on impose on work/life balance organisational expectations Economic impacts through Cycle allowance has been decreased mileage increased. Advocate allowance and cost of flexibility in repayment purchasing cycle equipment schemes

HIA of Traffic and Transport in Ballyfermot Background: • Public perception that high levels of air pollution due to increased through traffic Retrospective HIA with multiple aims: • Influence future transport policy including road safety initiatives in the local area • Inform a review of the DCC Road Safety Plan • Provide a health focus to a planned Air Quality and Noise Monitoring project • Influence future health service development and delivery in the local area

HIA of Traffic and Transport in Ballyfermot Information used: • Review of data on past and present levels of traffic • Evidence from literature on health impacts of transport • Review of data on past and present health of local residents • Focus groups and interviews with stakeholders and key informants

HIA of Traffic and Transport in Ballyfermot Key issues identified: • Safety including difficulties crossing the road at pedestrian lights, transport to and parking at schools • Public transport including personal safety, physical appearance of buses and poor disabled access • Increased journey times due to congestion • Impacts on mental health and wellbeing

HIA of Traffic and Transport in Ballyfermot Recommendations: • Establishment of intersectoral group to address key issues identified by the HIA at the local level • Measures to improve physical activity across the population and specifically among children • Measures to improve road safety • Better enforcement of local transport policy including parking restrictions • Review of transport policy for elderly and disabled users

Other HIAs of transport initiatives • Sweden: HIA of a road traffic project • UK: A HIA of the Eastern Corridor proposals in Plymouth’s East End • UK: HIA for Groundwork Safe Routes to School projects All accessible on HIA Gateway (link available through www.publichealth.ie/hia)

Further information • NZ Transport Agency Research Report 375 (2009): Applying health impact assessment to land transport planning • NHS Health Scotland (2007): Health Impact Assessment of Transport Initiatives • WHO/Europe Transport and Health and THE PEP

Contact details

Teresa Lavin Institute of Public Health in Ireland [email protected] 01 478 6300